Pet Nurse David Roberts (left) of Animal Emergency Room inspects a small kitten brought to them by Animal Care Services as pet nurse trainee Cassie Mesecher walks by on Friday, May 23, 2014. Animal Care Services contracts with Animal Emergency Room, 4315 Fredericksburg Rd, to take care of injured animals after hours during the week and on weekends. MARVIN PFEIFFER/ mpfeiffer@express-news.net

Photo By Marvin Pfeiffer/ Express-News

A black kitten with a mangled rear left leg peeks out of a box at Animal Emergency Room, 4315 Fredericksburg Rd, on Friday, May 23, 2014. The kitten was brought in by Animal Care Services, who contracts with Animal Emergency Room to take care of injured animals after hours during the week and on weekends. MARVIN PFEIFFER/ mpfeiffer@express-news.net

Photo By Marvin Pfeiffer/ Express-News

Pet nurse trainee Cassie Mesecher prepares a chihuahua brought in by Animal Care Services for x-rays at Animal Emergency Room, 4315 Fredericksburg Rd, on Friday, May 23, 2014. Animal Care Services contracts with Animal Emergency Room to take care of injured animals after hours during the week and on weekends. MARVIN PFEIFFER/ mpfeiffer@express-news.net

Pet Nurse David Roberts of Animal Emergency Room cleans the face of a small kitten brought to them by Animal Care Services on Friday, May 23, 2014. Animal Care Services contracts with Animal Emergency Room, 4315 Fredericksburg Rd, to take care of injured animals after hours during the week and on weekends. MARVIN PFEIFFER/ mpfeiffer@express-news.net

Photo By Marvin Pfeiffer/ Express-News

Pet Nurse David Roberts of Animal Emergency Room holds a small kitten brought to them by Animal Care Services on Friday, May 23, 2014. Animal Care Services contracts with Animal Emergency Room, 4315 Fredericksburg Rd, to take care of injured animals after hours during the week and on weekends. MARVIN PFEIFFER/ mpfeiffer@express-news.net

Photo By Marvin Pfeiffer/ Express-News

Animal Care Officer Liza Segovia with Animal Care Services inspects the paw of a chihuahua as she carries it into Animal Emergency Room, 4315 Fredericksburg Rd, on Friday, May 23, 2014. The chihuahua's rear legs appeared to be paralyzed, most likely from a ruptured disc in its lower back according to Kim Buck, DVM at the clinic. Animal Care Services contracts with Animal Emergency Room to take care of injured animals after hours during the week and on weekends. MARVIN PFEIFFER/ mpfeiffer@express-news.net

Photo By Marvin Pfeiffer/ Express-News

Pet nurse trainee Cassie Mesecher prepares a chihuahua brought in by Animal Care Services for x-rays at Animal Emergency Room, 4315 Fredericksburg Rd, on Friday, May 23, 2014. Animal Care Services contracts with Animal Emergency Room to take care of injured animals after hours during the week and on weekends. MARVIN PFEIFFER/ mpfeiffer@express-news.net

Photo By Marvin Pfeiffer/ Express-News

Kim Buck, DVM of Animal Emergency Room, walks outside to inspect a dog brought in by Animal Care Services to the clinic at 4315 Fredericksburg Road on Friday, May 23, 2014. The dog was suffering from possible distemper and mange and had a nasal discharge. Animal Care Services contracts with Animal Emergency Room to take care of injured animals after hours during the week and on weekends. MARVIN PFEIFFER/ mpfeiffer@express-news.net

Photo By Marvin Pfeiffer/ Express-News

Kim Buck, DVM (lower right) of Animal Emergency Room inspects a feral cat brought in by Animal Care officers Robert Araiza (left) and Aaron Cadena to the clinic at 4315 Fredericksburg Rd, on Friday, May 23, 2014. The cats rear legs were paralyzed and it had a fractured tail close to the body. It was later euthanized. Animal Care Services contracts with Animal Emergency Room to take care of injured animals after hours during the week and on weekends. MARVIN PFEIFFER/ mpfeiffer@express-news.net

Photo By Marvin Pfeiffer/ Express-News

Kim Buck, DVM (right) of Animal Emergency Room euthanizes a feral cat with the help of pet nurse David Roberts at the clinic at 4315 Fredericksburg Rd, on Friday, May 23, 2014. The cat was brought to them by Animal Care Services with paralyzed rear legs and a fractured tail near the body. Animal Care Services contracts with Animal Emergency Room to take care of injured animals after hours during the week and on weekends. MARVIN PFEIFFER/ mpfeiffer@express-news.net

Photo By Marvin Pfeiffer/ Express-News

Pet nurse trainee Cassie Mesecher (left) and receptionist/assistant Pet nurse Elora Gomez groom a black kitten with an injured rear leg at Animal Emergency Room, 4315 Fredericksburg Rd, on Friday, May 23, 2014. The kitten was broght to them by Animal Care Services, who contracts with them to take care of injured animals after hours during the week and on weekends. MARVIN PFEIFFER/ mpfeiffer@express-news.net

Photo By Marvin Pfeiffer/ Express-News

Don Cuba, an assistant pet nurse at Animal Emergency Room, 4315 Fredericksburg Rd, looks though a microscope for intestinal parasites called giardia trophozoites on Friday, May 23, 2014. Animal Care Services contracts with Animal Emergency Room to take care of injured animals after hours during the week and on weekends. MARVIN PFEIFFER/ mpfeiffer@express-news.net

Photo By Marvin Pfeiffer/ Express-News

Pet nurse David Roberts works with CoCo, a nine-month-old dog owned by Yesenia Cortez, at Animal Emergency Room, 4315 Fredericksburg Rd, on Friday, May 23, 2014. CoCo went into labor approximately 24 hours earlier and her condition worsened Friday afternoon. MARVIN PFEIFFER/ mpfeiffer@express-news.net

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Doctors and technicians care for a multitude of dogs hit by cars. Feral cats test their bedside manner. They must take extra care to avoid bites and scratches from sick bats, raccoons and skunks that are potential carriers of rabies.

And then there are the emotional, late-night vigils with owners of pets ailing from devastating wounds and debilitating illnesses of old age.

Dr. Kim Buck, co-owner of the clinic at 4315 Fredericksburg Road, said even after 25 years as a veterinarian, she still sees injuries that catch her off guard.

“It amazes me how animals can still be alive and how resilient they are,” Buck said. “They'll have healed wounds and doing great, but you know they had some major trauma and managed to live through that by themselves.”

Since 2000, the AER has been the first stop for many injured animals. Animal Care Services is one of three rescue partners that have a contract with the emergency room. The clinic provides care for injured strays or lost pets that will be sent on to the city shelter.

ACS spokeswoman Lisa Norwood said the agency doesn't have a 24/7 medical staff.

“We partnered with AER to have a mechanism after hours,” Norwood said, “to ensure if there's a critical case, such as a pet hit by a car or injured inside a home, we can aid it as quickly as possible.”

On an average week night, the doctor on overnight shift — 5 p.m. to 8 a.m. — will treat from three to five injured animals brought in from across the city. On weekends, the number increases to as many as 20, as does the severity of injuries, said members of the staff that includes two full-time doctors, three part-time doctors and 10 technicians.

Buck said it's rewarding to save an animal's life, but there can't always be a positive outcome with emergency cases.

“Sometimes I feel, if I had to do a lot of euthanasias, just ... tired,” she said, “But kind of like I helped that night. I helped the pets the best that I could.”

“We make sure they're comfortable,” Hossalla said. “We care for the animals and make sure they get love and care.”

A year ago, Buck and her business partner, Dr. Michele King, bought the clinic from Dr. Danette Schweers, who founded the AER. Schweers, board-certified with American Board of veterinary practitioners, still works a Sunday shift.

Buck said she respects the ACS officers who bring the pets destined for the city shelter. She's heard how they've coaxed out wounded pets hiding in brush and even followed a hurt dog in 95-degree weather for an hour to make sure he got help.

“They have a very tough job,” Buck said. “I can't imagine doing the job they do.”

One recent Wednesday night, ACS officers transported two American Staffordshire terriers that had been rescued by San Antonio firefighters from a house fire. Suffering badly from smoke inhalation, the dogs were stabilized by an AER veterinarian before they were transported to ACS for further care. In the morning, ACS chief veterinarian, Dr. Marilyn Gotbeter and her staff continued treatment for possible cornea damage and burns in the windpipe. The brindle terrier was more stable than her black-and-white companion.

By Saturday morning, the critically injured dog's health had declined. The staff made the decision to have her humanely euthanized.

Gotbeter was quick to praise the emergency room team, saying that the dogs would not have lived through the first night without their care.

Buck said that, although Animal Care Services contracts with AER, the emergency clinic is not part of the shelter, so residents can't bring injured strays to their office. She said residents can call 311 to report a hurt animal. But because of the client/patient relationship, she said, AER can't release information if someone calls to check on the status of an injured animal they reported.

The shifts range from slow, especially during Spurs games, to a frantic pace in the late hours. But the moments that linger take place in the reception area, where heartbreaking decisions are often made. Sometimes a family will fill an exam room, trying to decide the fate of a pet with a chronic disease. Some pet owners visit the ER at night with dying pets, Buck said, to spare longtime veterinarians, who have bonded with their furry family members.

A big part of their job is being there for the pet owners, Buck said, as they struggle with decisions, financial worries or grieve about a pending loss.

“Most of the time you're helping people,” she said. “A big part is listening to the owners. You have to love people too to be a veterinarian.”